Online ISSN: 2515-8260

Keywords : ECG

A Case control study on the Association of Serum Ferritin levels with Acute Myocardial Infarction

Vadiga Ramana Kumar, Atul Pundlik Ramteke, Guguloth Prem Kumar

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 2647-2655

Background: To evaluate the serum ferritin levels in patients with acute myocardial infarction. To inspect normal healthy individuals with non-cardiac chest pain for serum ferritin levels. To distinguish ferritin levels persisting in both the study population. Comparing serum ferritin levels to the probability of developing acute myocardial infarction. To study relevance of serum ferritin level to acute myocardial infarction.
Material and Methods: A case controlled study was held by Department of General Medicine, Government General Hospital, Suryapet, Telangana, India from December 2021 to September 2022. The study consisted of male patients with myocardial infarction for determining the association of serum ferritin to acute myocardial infarction.
Results: The statistical analysis data for the evaluation of study details for different diagnostic test between cases and control group and determines significance between them. Comorbidities associated with cases and control shows that evidence of diabetes mellitus. The comparison of ferritin and lipid profile no significance existed. On differentiating ferritin administrated value to that of day 3 shows statistical significance. While comparing ferritin and glycaemic control, correlation prevailed. A mixed results were obtained from performed study that proved insufficient to correlated ferritin with myocardial infarction.
Conclusion: The study contradicted the hypothesis. Neither of the tested iron biomarkers confirmed the iron hypothesis, based on the meta-analysis. These finding suggest that the evidence is not robust enough to support the connection among iron and cardiovascular disease. This discrepancy in results could be due to the study's use of different iron markers. Despite the large amount of data that has been published to far, the importance of iron in CVD is still up for debate.


Dr. Ashok Kumar Dash

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 4, Pages 3694-3697

Background: Dengue is a febrile illness caused by infection with 1 of 4 dengue viruses transmitted by the Aedes mosquito. The present study was conducted to assess ECG manifestation of dengue fever.
Materials & Methods: 82 dengue fever patients were enrolled in study. Clinical features and ECG changes such as sinus bradycardia, sinus tachycardia, non- specific ST changes and RBBB were recorded.
Results: Out of 82 patients, males were 50 and females were 32. We observed that common clinical features were fever in 75, myalgia in 23, headache in 41, abdominal pain in 32, rashes in 15, arthritis in 17, palpitations in 20 and diarrhoea in 5 cases. We found that common ECG changes were sinus tachycardia in 6, sinus bradycardia in 30, non- specific ST changes in 12 and RBBB in 4 cases. The difference was significant (P< 0.05).
Conclusion: Common ECG abnormality in patients with dengue fever was sinus bradycardia.


Dr. Minoti Baruah, Dr. Bandana Mahanta

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 1382-1389

Introduction: Awareness with recall (AWR), originally coined as intra-operative awareness, is a recognized risk of general anesthesia (GA). Based on individual factors, patients respond differently to GA. The safety of GA has increased drastically over the past 20 years; however, there is continued opportunity for assessment, evaluation and treatment of AWR. Gibbs, Gibbs and Lennox (1937) first identified AWR in 1937.
Materials and Methods: The Present study was conducted at the Department of Anaesthesiology and Critical Care, Tertiary care center, Guwahati, Assam. Which includes 50 patients who underwent different routine general surgeries and 50 patients from Emergency. Pre-anaesthetic evaluation was done and noted down. In the operating room IV line established, multichannel monitor attached and standard monitoring including baseline pulse, NIBP, SPO2 and ECG connected. Entropy and NM monitoring equipment was attached. The choice of inducing agent, neuromuscular blocker and maintenance for general anaesthesia was based on the patient and nature of surgical procedure.
Results: These 200 patients were interviewed as per the protocol in hospital on the day of surgery. Our study found that among these 200 patients, 2 patients reported remembering something between going to sleep and waking up from anaesthesia, thus 2 cases of awareness were identified. 7 patients reported dreaming and 6 cases of possible awareness were identified.
Conclusion: Awareness occurs despite the usual clinical monitoring of anaesthetic depth like BP, HR and even with the use of entropy. There is currently no evidence that awareness and recall could be prevented by monitoring consciousness with sophisticated methods such as BIS or entropy. If a patient has suffered from awareness and recalls this postoperatively, psychiatric consultation and followup is recommended

The study of biochemical (CPK-MB) ,ECG, and Echocardiographic changes in patients of snake bite

Dr.Roopesh Singh Kirar, Dr.Ritesh Yadav

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 2055-2064

Background:Snake bite is an occupational hazard for farmers and farm laborers in the Indian
subcontinent. Every year approximately 15,000 people reportedly died due to snake venom
interaction in India alone. However, unreported deaths are estimated to be many times greater
than the reported cases in the subcontinent.
Materials & Methods:ThisCross Sectional Observational Study was carried on sample size of
75 patients of snake bite admitted in Ward/ICU, Department Of Medicine, NSCB Medical
College, and Jabalpur on patients of snake bite reporting from all over mahakaushal area of
central India from March 2017 to August 2018.
Results: CPK-MB analysis shown to have highest raised values in neurotoxic group that is
32.3±0.9 IU/L which was higher in cases where local signs were prominent, 34.0±1.1 IU/L and
in cases without local signs it was lower 30.7±1.6 IU/L. CPK-MB values were for vasculotoxic
bites was also raised 27.3±1.2 IU/L, while for non-poisonous snake bites it was below upper
limit, 21±2.1 IU/L. A total of 39.2% (n=33) patients shown to have positive ECG findings while
rest 60.7% (n=51) shown no abnormality in electrocardiogram. Analysis of 2D-ECHO findings
was done for pattern of positive findings and found that most common positive finding was
pericardial effusion with 9 (10.71%) patients followed by 6 (7.1%) patients showed diastolic
dysfunction, and 5 (5.9%) patients each shown to have systolic dysfunction and RWMA.
Conclusion: CPK-MBanalysis shown to have highest raised values in neurotoxic group which
was higher in cases where local signs were prominent, and in cases without local signs it was
lower. Abnormal ECG was significant predictor of mortality in vasculotoxic snake bites.
Echocardiography was a significant predictor of mortality in neurotoxic bites.


Dr.Balwant Singh Patle ,Dr.Vikas Yadav, Dr.Krithika T T, Dr. O P Jatav

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 2937-2946

Chronic Kidney Disease (CKD) is recognized as a major medical problem
worldwide. Electrocardiogram (ECG) remains an essential tool despite the development of
modern technologies, for evaluation of cardiovascular disease.
To study the electrocardiographic findings along with the associations with the laboratory
variables and prevalence of cardiac arrhythmias in patients of chronic kidney disease
undergoing haemodialysis.
The study was conducted on 100 in-patients who were undergoing Haemodialysis in G.R.
Medical College, Gwalior. A standard 12 lead ECG was obtained just before and after the
haemodialysis procedure. The electrocardiograms was reviewed on descriptive reports of
variables: Rhythm, Heart rate , P wave abnormalities, LVH, QT interval/ QTc, ST segment
changes. Patient was placed on the Holter monitor for 24 hours just an hour before the
In the study subjects , there were 51% of them who had serum creatinine of (5.1-10mg/dL)
and 2% had serum creatinine of ( > 20 mg/dL). There were 37% of the study subjects who
were Smoking and 27% of them were Alcoholics, 81% were Hypertensives , 19% were
having Diabetes Mellitus and 14 % were Obese. It was observed that 5% of the subjects
showed Atrial Fibrillation on ECG after Dialysis and 95% of them showed a Sinus
Rhythm. Changes in the ST segment and Tall T wave on ECG were observed in 25% and
35% of the study subjects. Supraventricular Ectopic findings were observed in 19% before
dialysis and 48% during dialysis and 15% after dialysis respectively. On ECHO, 60% of
subjects showed Left Ventricle Hypertrophy and 28% had Diastolic dysfunction.

Study of Pulmonary Hypertension in Patients with Chronic Kidney Disease

Meroz Pillarisetty,Ganga Prasad, Aparna

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 11633-11650

Background:To study the prevalence of Pulmonary Hypertension (PH) in patients with Chronic Kidney Disease (CKD).
Materials and Methods: The present study assessed the prevalence of PH in 50 patients with CKD, at DR.PSIMS & RF, Chinnavutpalli, Gannavaram.
Results: The commonly affected age group in study population was 31-50 years. The mean age of patients was 48.98±12.53years. Diabetes Mellitus was present in 15 (30%) and Hypertension in 48 (96%).  Majority of the patients were in CKD stage 5, i.e.,46 (92%), CKD stage 4 -3 (6%), CKD stage 3- 1(2%). The prevalence of PH in CKD is 22 (44%). PH was not found in the patient with CKD stage 3. PH was found in 2 of the 3(66.6%) patients with CKD stage 4. Out of the 46 CKD stage 5 patients, 20 (43.4%) had PH. With reference to the severity of PH with CKD, the two patients of PH  CKD stage 4 had moderate PH . Out of the 20 patients of PH with CKD stage 5, 10 patients had mild PH, 9 with moderate PH and 1 with severe PHOn Chest X ray, descending right pulmonary artery dilatation and cardiomegaly were seen in more number of patients with PH, compared to those without PH. (p<0.001). In this study, LV systolic dysfunction was present in 18 out of 50 patients (36%). Among 22 patients with PH, it was present in 13 (59.09%). Among 28 patients without PH, it was present in 5 (17.85%). LV systolic dysfunction was significantly higher among the patients with PH compared to those without PH. The mean EF of all patients with CKD is 55.62± 9.54. The mean EF of patients with PH and without PH in the study was 50.50±9.78% and 59.64±7.26% respectively. (p<0.02). LV diastolic dysfunction was present in 41 out of 50 patients (82%). Among 22 patients with PH, it was present in 20 (90.9%). Among 28 patients without PH, it was present in 21 (75%). Prevalence of LV diastolic dysfunction was significantly higher among the patients with PH, compared to those without PH. RV dysfunction was present in 1(3.6%) and in 10 (45.5%) in patients without PH and in patients with PH respectively. Significant difference was found with RV dysfunction more prominent in patients with PH than in patients without PH (p<0.001). 64%of the patients studied had CKD of less than 6 months including 24%of new cases. 16%of the patients had CKD between 6 months and 1year. 20% had CKD of more than 1yr. In relation to PH, out of the 12 new cases of CKD,7 (31.8%) had PH and 5(17.9%)were without PH. Of the 20 patients having history of CKD less than 6 months (excluding new cases), 7 (31.8%) had PH and 13 (46.4%) were without PH. Out of the 8 patients  of CKD between 6 months and 1 year,4(18.2%) had PH and  4(14.3%)were without PH. In patients having CKD of more than 1 year, 4 (18.2%) had PH and 6 (21.4%) were without PH.
Conclusion: The study showed that PH is common in patients with CKD. Left Ventricular systolic and diastolic dysfunctions are strongly related to the outcome of these patients. Unexplained dyspnoea in patients with CKD must be evaluated for PHPulmonary Hypertension, CKD, Chest X-Ray, Left Ventricle, Mortality, ECG, 2D-Echo

Prevalence of cardiovascular autonomic neuropathy in type-2 diabetes mellitus and role of corrected QT interval for its diagnosis

Dr. Rambabu Singh, Dr. ArvindKankane,Dr. BasavarajShirol

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 1182-1188

The prevalence of cardiac autonomic neuropathy (CAN) in type 2 DM patients increases with
the duration and poor glycemic control. Patients with CAN are at increased risk for
autonomic dysfunction like resting tachycardia,abnormal systolic and diastolic function
leading to syncope and dizziness, prolonged QT interval, silent ischemia/infarction, lethal
arrhythmias and sudden death.Usage of 5 simple and cheap bed side tests for autonomic
function and corrected QT interval from ECG are helpful in early diagnosis of CAN. Early
recognition of CAN is helpful in delaying effects of CAN by strict control of blood sugar and
following healthy life style. Our study was conducted on100known and newly diagnosedType
2 Diabetes Mellitus patients<60 years whopresentedto Medicine OPD and admitted in IPD
wardsin Maharani LaxmiBai Medical College.Out of total 100 patients,49% had normal
score(0,1); 25% had borderline score(2,3,4); rest 26% had abnormal score ≥5; the prevalence
of CAN was 51%.Among 100 patients 47% patients were foundwith poor glycemic control
(HbA1C ≥ 8),in these 17% had early and 21% had definite CAN. Out of 100 patients of the
study, 55% patients had QTc>440ms out of which 17% had early and 23% had definite CAN.
The CAN also increased with older age group. So it is important to diagnose CAN early in
asymptomatic diabetics. There is significant correlation between CAN and QT prolongation.
QT interval in ECG can be used to diagnose CAN with reasonable sensitivity and specificity.
Usage of 5 bedside autonomic function tests are very helpful in early diagnosis of CAN.Strict
control of blood sugar can delay the early development of CAN. Intensive control of blood
sugar can delay the early development of CAN.

Correlation of peak amplitude ECG between leads Based on the condition of the heart

Sabar Setiawidayat

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 2, Pages 862-872

Non-invasive cardiac examination in standard clinic is still using 12-lead electrocardiograph. The results of the examination are presented on ECG paper or on the monitor screen. A normal electrocardiogram on one lead is not necessarily normal for the other lead, because each lead represents a certain part of the heart so that one by one is necessary. This examination takes time so that it can increase the stage of the disease if the patient turns out to be in an abnormal condition. This paper aims to correlate the peak amplitude of each lead to normal and abnormal heart conditions. If it is known that the peak amplitude is correlated between the leads, the other leads do not need to be checked, so that the diagnosis time will be obtained faster. Cardiac biosignal data that has been sampled with a frequency of 250 Hz is a discrete signal that can be stored digitally in a database. 10 samples of normal conditions and 10 samples of abnormal conditions were analyzed using Saphiro-Wilk so that the data were normally distributed. Spearman correlation analysis is used to get peak amplitude correlation between leads. The results showed that for abnormal conditions with a significance of 0.01 there was a correlation between the peak P lead I with leads III and V5, while for normal conditions there was a correlation between peak P lead I and leads V3 and V4. In abnormal conditions there is a correlation between peak R lead II and V6, while in normal conditions there is a correlation between peak R lead I and aVF.

Assessment of cardiovascular manifestations of hyperthyroid disorder patients

Dr.Mayank Panwar,Dr.Akanksha,Dr. Bijoy Jyoti Saikia, Dr.Peddi Shreya

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 11, Pages 9414-9417

Background: Hyperthyroidism is defined as excess concentration of thyroid hormones
in the body due to either increased synthesis of the thyroid hormone, increased release
of preformed thyroid hormones, or from endogenous or exogenous extrathyroidal
sources. The present study was conducted to assess cardiovascular manifestations of
hyperthyroid disorder patients.
Materials & Methods: 104 patients of hyperthyroidism of both gendersunderwent
clinical evaluation, basic laboratory tests like CBC, RFT, LFT and ECG and 2D ECHO
were performed in these patients to evaluate the presence of any cardiac manifestations.
Results: There were 34 males and 70 females. Age group upto 40 years had 20, 41-60
years had 34 and >61 years had 50 patients. Common symptoms were pallor in 90,
edema in 86, moist skin in 74 and eye signs in 53. Cardiovascular symptoms recorded
were chest pain in 82, palpitations in 95 and breathlessness in 60. Among 104 patients,
ECG changes were seen in 42 patients. Out of this, sinus tachycardia was seen in 65%,
AF in 10%, ST T changes in 6%, RVH in 7%, LVH in 11% and RBBB in 5%. The
difference was significant (P< 0.05).
Conclusion: Cardiovascular manifestations are quite common in hyperthyroid patients.

Noise Removal in ECG Signal Using Digital Filters

N. Sasirekha; P. Vivek Karthick; T. Premakumari; J. Harirajkumar; S. Aishwarya

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 2, Pages 5145-5149

The Electro Cardio Gram (ECG) is a parametric index to diagnose heart diseases. During the process of acquisition of the ECG signals, it is added up by large amount of noise, which affects the patient diagnosis with respect to telemedicine. The noisy ECG signals have drift in baseline, motion electrodes artefacts, interference of line, muscle contraction noise, etc. Noise reduction is accomplished by making using of adaptive filter which employs wavelet transform. Computer simulation results are shown for the improvement in performance. This methodology adapted successfully removes various types of noise with Signal to noise ratio (SNR). The impact of noise and removal of it are shown in the waveforms and the methodology adopted has produced 82% improvement on the SNR of de-noised signals.

Association Of Spot Urinary Albumin Creatinine Ratio (UACR) With Coronary Artery Disease

Sanyukta H; A.H. Inamdar; Sunil Kumar

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 2, Pages 1962-1966

Background: Microalbuminuria has been recently found to be a marker of
atherogenesis. It is associated with various risk factors of atherogenesis and damage of the
vascular endothelium. There have been few studies in which it has been found that
mortality in cardiovascular disease are increased with microalbuminuria. Urine is
collected over 24 hours and this study has similar sensitivity as urinary albumin creatinine
ratio. A urinary albumin to creatinine ratio is as sensitive as a 24 hours urine study even
though it itself is a gold standard test. In patients with CAD other factors have been
explored then urinary albumin has been recently identified.
Objectives: To assess correlation between urinary albumin creatinine ratio with coronary
artery disease and to correlate Urinary albumin creatinine ratio (UACR) with
Framingham heart study Cardiovascular disease (FHS-CVD) score in all patients of
coronary artery disease.
Methodology: In this study which is cross sectional, Subjects to be included in the study
will be explained regarding the study and proper consent will be obtained. A random urine
sample will be collected. Urinary albumin concentration will be measured by auto analyser
and urine albumin creatinine ratio will be calculated. The values of the same will be
recorded and will be statistically analysed.